Page 7 - GP Spring 2019

Statins: Their Purpose, Mechanism, Prevalence,
Side Effects, Countermeasures and Alternatives

By Michael Acquista, DDS

According to Akira Endo, whose research detail and depth; it is beyond the scope noic) and DHA (docosahexaenoic) (fish
on fungi and cholesterol led to the devel- of this paper, but well worth reviewing. oil). Research indicates that regular fish
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opment of Statin drugs, “Cholesterol is es- Medications and foods that interact are also consumption and/or pharmaceutical- grade
sential for the function of all human organs, discussed. Side effects include cognitive omega-3 fatty acid supplementation is in-
but it is nevertheless the cause of heart dis- (memory loss, transient global amnesia, dicated for all people with high cholesterol
ease.” “The Framingham Heart Study was forgetfulness and confusion) as well as in- blood levels. The reason behind recom-
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carried out by the National Heart Institute creased liver enzymes (liver damage), mus- mending omega-3 fatty acid consumption
in Framingham, Ma. (1961). It provided cle problems including pain, muscle weak- is as follows: Cardiovascular disease is a
the first solid and unarguable evidence that ness and potentially more severe problems chronic inflammatory disease and omega-3
individuals with higher blood cholesterol (rhabdomyolysis). Another potential ad- fatty acids (EPA + DHA) have an anti-in-
levels at the time of the baseline examina- verse effect is an increased risk for dia- flammatory (systemic) effect.
tion were more likely to experience a myo- betes, but this paper will not discuss that.
cardial infarction in the subsequent years of Next is the topic of Coenzyme Q10. Also
follow-up.” ¹ Evidence was already grow- Statin users are advised not to take fibrate known as Ubiquinone, because it is ubiq-
ing that high blood cholesterol levels and or niacin medications concomitantly, as uitous (being everywhere) in every cell
heart disease were linked, and scientists in serious muscular side effects are possible of the body, CoQ10 is present in the mi-
the 1950’s and 60’s started searching for (rhabdomyolysis). Also, consumption of tochondria, the “powerhouse of the cell”.
a pharmaceutical agent that could lower grapefruit juice as well as some other trop- This fat soluble substance is similar to a vi-
cholesterol levels. Statins are lipid-lower- ical fruits and juices are contraindicated as tamin, and is concentrated in those organs
ing medications that act by competitively these inhibit the metabolism of statins. with the highest metabolism (i.e., energy
inhibiting HMG-CoA reductase. The first consumption) such as the heart, kidney
statin, Lovostatin, received FDA approval Regarding the adverse cognitive effects of and liver. “The primary biochemical ac-
in 1987. The mevalonate pathway is the statins, the effects are often dose-dependent tion of CoQ10 is as a cofactor in the elec-
essential metabolic pathway that produces and reversible with cessation of the medi- tron-transport chain, in the series of redox
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cholesterol, coenzyme Q10, and all steroid cation. Some sources state that the reason reactions that are involved in the synthesis
hormones as well as thousands of other for these adverse effects is unknown. How- of adenosine triphosphate.” Adenosine
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products. This inhibition occurs long be- ever, myelin sheaths, which line the axons triphosphate (ATP) is the organic chemical
fore the actual production of cholesterol (in (the long projections of the neurons in the that produces energy to drive muscle con-
the mevalonate pathway) and it necessar- brain and throughout the nervous system) traction, nerve impulse propagation, chem-
ily inhibits all products subsequent to this consist of phospholipids, cholesterol, and ical synthesis, etc., called the “molecular
step before and after cholesterol synthesis. protein. The insulation provided to the ax- unit of currency” of intracellular energy
“Statins have been found to reduce cardio- ons by layers of myelin increases the speed transfer. “Statins block the production of
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vascular disease and mortality in those who of nerve transmission. Myelination mostly farnesyl pyrophosphate, an intermediate in
are at high risk of cardiovascular disease. occurs early in life, but “remyelination” the mevalonate pathway, which is respon-
The evidence is strong that statins are ef- can occur throughout life. Remyelination sible for the production of coenzyme Q10
fective for treating cardiovascular disease refers to the creation of new myelin sheaths (CoQ10). This knowledge has prompted
in the early stages of the disease (secondary (from oligodendrocytes) on demyelinated the hypothesis that reductions in plasma
prevention) and in those at elevated risk but CNS axons. There is research that contends CoQ10 concentrations contribute to SAMS
without cardiovascular disease (primary that statin therapy can inhibit remyelin- (Statin-associated muscle symptoms).”
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prevention).” 2,3
ation in the CNS. Compromised myelin Physicians are trying to lower high blood
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Cardiovascular disease is the leading cause sheaths due to deficient cholesterol levels levels of cholesterol in order to reduce the
risk of heart disease, so they prescribe sta-
of death among adults in the United States. can alter nerve transmission and may be the tin medications. But statins lower CoQ10
According to the National Center for Health cause of adverse cognitive effects. All ad- levels, and CoQ10 is a cofactor in energy
Statistics, from 2003-2012, the percentage verse side effects influence the risks versus production. Thus, statins can potentially
of adults age 40 and over using statins in- benefits ratio, indications and dosing levels compromise your heart’s ability to pro-
creased from 18 to 26%. Lipitor (Pfizer), for statins. duce energy. Actually, the aforementioned
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the biggest selling pharmaceutical of all Due to the potential of statins to cause study casts doubt on the efficacy of CoQ10
time, had peak sales in 2006. The focus of liver damage, liver function tests are rec- supplementation, and multiple studies on
this article will be on the adverse effects ommended periodically to verify that the www.Pubmed.gov are equivocal. “Because
and potential countermeasures available to drug is well-tolerated. If liver function CoQ10 is a cofactor in the generation of
alleviate some potentially negative effects. adenosine triphosphate, supplementation
tests reveal that statin medications are not has also recently been studied in patients
The Journal of the American College of well-tolerated, physicians will often rec- with heart failure, which is inherently an
Cardiology discusses potential adverse ommend the pharmaceutical, Lovaza, or energy deprived state. The Q-SYMBIO
side effects of statin medications in great omega-3 fatty acids EPA (eicosapentae- trial found that CoQ10 supplementation
www.nysagd.org l Winter 2019 l GP 7